Second Opinions

SECOND OPINIONS: Preventive Care: Are You Covered?

Christy Tinnes and Brigen Winters, with Groom Law Group, answer employer questions about health care reform.

By PS | October 28, 2015
Page 1 of 6 View Full Article

The Patient Protection and Affordable Care Act (ACA) generally requires group health plans to cover certain preventive care benefits at 100% with no cost-sharing.

These benefits include:

  • Evidence-based items or services with a rating of “A” or “B” under recommendations from the United States Preventive Services Task Force (USPSTF) [http://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations-by-date/];
  • Immunizations recommended by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control [http://www.cdc.gov/vaccines/schedules/hcp/index.html];
  • Preventive care and screenings for infants, children, and adolescents under Health Resources and Services Administration (HRSA) guidelines [https://www.aap.org/en-us/professional-resources/practice-support/Pages/PeriodicitySchedule.aspx]; and
  • Preventive care and screenings for women under HRSA guidelines [http://www.hrsa.gov/womensguidelines/].

PHSA § 2713(a); 29 CFR § 2590.715-2713(a). 

Experts from Groom Law Group answer some common questions about these requirements and outline recent guidance that plans should consider for 2016.

SPONSORED MESSAGES